22 October 2016
Hygienic washrooms are particularly important for adolescent girls to ensure privacy as well as safety. Photo: World Vision
Hygienic washrooms are particularly important for adolescent girls to ensure privacy as well as safety. Photo: World Vision

2.4 billion people have no access to decent sanitary facilities

What would improve your life significantly? A university degree? A well-paid job? A comfortable home? Melinda, a young mother from Madagascar, would reply: A toilet.

It is, in fact, the need of 526 million women worldwide.

Melinda and her daughters used to walk to the forest six kilometers away from home just to relieve themselves in a not-so-open space.

It was unhygienic and dangerous, and they dared not go alone because of the possibility of sexual harassment or rape.

Perhaps it is hard for you to imagine that one-third of the global population, or more than 2.4 billion people, do not have access to adequate sanitary facilities.

Nearly a billion people from India, Indonesia, Pakistan, Nepal, Cambodia, Ethiopia, Sudan and Mozambique still practice open defecation.

Today, Nov. 19, is World Toilet Day. The United Nations launched the observance to raise awareness on the extent of the problem. 

So many people around the world don’t have access to a toilet, although it is a basic human right to have clean water and sanitation.

Washroom facilities are particularly important for adolescent girls. The absence of such facilities in schools has prevented senior primary and junior secondary schoolgirls from attending classes during their menstrual cycles to avoid taunts from classmates.

“I did not completely want to stop going to school, but imagine being in a place where the cycle could start anytime and you had nowhere to go and help yourself,” recalls Malita, a 19-year-old mother of two who dropped out of school some years ago.

The story is now very different. World Vision constructed sanitary toilets, including those exclusively for female students, at Malita’s old school.

The action has effectively extended the average number of years that girls attend school and subsequently minimized the problem of child marriage.

Open defecation spreads germs and diseases. According to the UN, India, the country with the highest number of people practicing open defecation, also has the highest fatality rate among children aged five or below, as well as severe malnutrition problems among children.

Worldwide, 1,000 children aged five or below die every day as a direct result of inadequate water, sanitation and hygiene.

Long-term repeated diarrhea, which can be traced to poor sanitation, causes malnutrition among children. Other diseases resulting from unhygienic practices include cholera, typhoid fever and ascariasis, which are all preventable.

Indian Prime Minister Narendra Modi has promised to build toilets first, temples later. But although hardware is important, it is not enough to eliminate the practice of open defecation. 

Educating the public on the importance of sanitation is equally important.

The Community-Led Total Sanitation (CLTS) is a holistic program designed by Kamal Kar in 2000 to educate people about the threats and dangers posed by the practice of open defecation.  

Under the program, hygiene leaders are also elected to conduct patrols around the community to discourage villagers from the practice. 

In the long run, it is hoped that villagers can get rid of their unhygienic habits.

The program has widely recognized and adopted since 2011.

World Vision supports the CLTS program and has adopted it for the Kraing Serey community, a rural village in Cambodia, where 95 percent of the villagers used to practice open defecation.

After attending a World Vision seminar, the villagers understood the threats to their health and environment.

It took less than a year for the community to eliminate the practice of open defecation. One of the benefits is a significant drop in the number of cases of diarrhea.

Though feces are notorious for spreading germs when disposed of improperly, they are important in agricultural communities as fertilizers.

Scientists from the Hamburg University of Technology have learned from an indigenous Amazon tribe how to turn human feces into fertilizers by using lactic acid bacteria, and also through the use of worms and wood chips.

The method is now being used in Nepal and some countries in Eastern Europe where there is a lack of sewerage system.

A team from the University of Colorado Boulder, supported by Gates Foundation, has developed a solar-powered toilet that can heat human waste to high enough temperature to create biochar, a highly porous charcoal, for agricultural uses.

On Sept. 25-27, the UN General Assembly convened a high-level plenary meeting in New York for the adoption of a post-2015 development agenda. 

Commitment for the sixth goal initiative, ensuring access to water and sanitation for all, was made by member states. It is hoped that the goal can be achieved by 2030.

This article appeared in the Hong Kong Economic Journal on Nov. 18.

Translation by Darlie Yiu

[Chinese version中文版]

– Contact us at [email protected]


These boys used to relieve themselves by the river. Now their home has a clean toilet. Photo: World Vision

This little girl has to dig a hole before relieving herself as there are no sanitary facilities in the village. Photo: World Vision

Villagers join hands to build a toilet. Photo: World Vision

Peggy Tu is the public education manager at World Vision Hong Kong.

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